AMMAN: Syrian regime warplanes struck the besieged eastern suburbs of Damascus for the sixth day on Monday in an ongoing assault that has killed at least 60 civilians as first responders described victims trapped under rubble and “shouting in pain.”

At least 120 airstrikes and more than 1,000 artillery shells have struck rebel-held East Ghouta since last Tuesday, Abu Ahmad, a Civil Defense spokesman in Douma city told Syria Direct on Monday.

An estimated half-dozen airstrikes reportedly killed five civilians in the rebel-held suburbs on Monday. The day before, more than 30 airstrikes and 300 artillery shells struck about a dozen separate towns and villages in East Ghouta, killing 18 people and injuring more than 100, the local, pro-opposition Ghouta Media Center reported.

“We’re still trying to rescue people trapped underneath the rubble,” said Siraj Mahmoud, a spokesman for the Civil Defense in East Ghouta. “It’s extremely difficult with the ongoing bombings.”

“Trapped people are shouting in pain, the sound mixing with the noise of the bombs,” said Mahmoud.

East Ghouta, a collection of rebel-held suburbs immediately northeast of regime-held Damascus, is part of a de-escalation deal brokered by Iran and Russia in May that established four ceasefire zones across the country.

Government forces have encircled the enclave since 2013. The siege of East Ghouta tightened in recent months after regime forces closed a key trade crossing into the enclave and shut down a network of smuggling tunnels that once brought food and other supplies to an estimated 400,000 residents.

The latest wave of bombings began last Tuesday after a local rebel faction attacked a government military base adjacent to the opposition-held East Ghouta town of Harasta.

The latest regime airstrikes have included the use of cluster bombs, Civil Defense spokesman Mahmoud told Syria Direct. Cluster bombs are high-explosive anti-personnel munitions prohibited by an international charter that Syria has not signed.

Bayan Rehan, a Douma resident and member of the opposition-run Women’s Council there, said she lost a relative when a regime airstrike landed near her home earlier this week.

“We haven’t slept or eaten in days,” Rehan told Syria Direct on Sunday. “We’re overcome by fear of the bombings.”

The past week of violence has left streets in Douma “empty,” with residents too fearful to leave their homes, Rehan said.

“We don’t know what the coming days hold for us.”

‘We can’t replace what we’ve lost’

At least four members of the Civil Defense in East Ghouta have been killed by airstrikes and artillery shells during the latest spate of bombings, spokesman Mahmoud told Syria Direct on Monday.

“We can’t replace what we’ve lost,” he said, referring to personnel, ambulances and medical equipment. “For the first time, I feel powerless.”

Even before the latest airstrikes and shelling, years of war and siege had left East Ghouta’s medical infrastructure severely limited. Many hospitals, medical centers and ambulances have been repeatedly damaged, while basic medicines are in short supply.

As a result, even victims of airstrikes who are found and pulled out from under the rubble by the Civil Defense may not stand a chance after they are taken to East Ghouta’s understaffed and undersupplied hospitals.

Only a “small” percentage of the rescued survive, said Mahmoud. “Our task is only the first half of saving their life.”

“When I hear the sound of someone fighting death under the rubble, I run to them,” Abu Ahmad of the Douma Civil Defense told Syria Direct on Monday. “I’m with him in his last moments.”

But with limited resources and ongoing airstrikes, the Civil Defense are fighting an uphill battle, says spokesman Mahmoud.

“All we can do is raise the rubble and collect the pieces underneath.”

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